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      Total Video-Assisted Thoracic Surgery Sleeve Lobectomy: Suture by Both Hands

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          Abstract

          Bronchoplastic procedures offer better long-term survival and quality of life with less morbidity and mortality than pneumonectomies. However, minimally invasive sleeve lobectomy is rarely reported, and the procedure requires more skill even for experienced hands. We report a total video-assisted thoracoscopic right upper sleeve lobectomy for a patient with centrally located lung cancer.

          Most cited references5

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          Sleeve lobectomy versus pneumonectomy for lung cancer: a comparative analysis of survival and sites or recurrences.

          J. Grégoire, Paul F Jacques, Michel Piraux … (2004)
          Sleeve lobectomy (SL) in a lung-saving procedure indicated for central tumors for which the alternative is pneumonectomy (PN). Although it has been suggested that it may provide as good if not better survival results than pneumonectomy in the treatment of lung cancer, there are very few reports of clinical series comparing operative mortality, survival, and sites of recurrences between these procedures. Survival and sites of recurrences were analyzed and compared in 1,230 consecutive patients who underwent PN (n = 1,046) or SL (n = 184) in a single institution. Sleeve lobectomy was always done when technically possible. Thus PN was reserved for lesions that could not be removed by a bronchoplastic procedure. Pathologic staging was accomplished by nodal sampling except for N2 and selected N1 patients who underwent mediastinal lymphadenectomy. Ultimately, all patients were staged according to the 1997 TNM nomenclature. There were 3 operative deaths of the 184 SL patients (operative mortality of 1.6%) and 55 operative deaths of the 1,046 PN patients (operative mortality of 5.3%, p = 0.036). Follow-up was complete for all 1,230 patients. For the entire group, survival at 5 years was 52% after SL and 31% after PN (p < 0.0001). These rates for patients with complete resection were 58% for SL and 33% for PN (p = 0.021). There was also a significant difference in survival favoring SL for patients with pathologic stage I (p = 0.018) and stage II (p = 0.005) disease. When recurrences occurred (n = 577), the site of first recurrence was local in 22% of patients with SL and in 35% of patients with PN. Sleeve lobectomy can be done with a much lower risk of operative mortality than PN. Although it is recognized that stage for stage, PN patients likely have more advanced disease, long-term survival and local control are significantly better when complete resection can be achieved by SL.
          Article 0 comments Cited 34 times – based on 0 reviews     Review now
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            Video-assisted thoracic surgery sleeve lobectomy: a case series.

            Ali Mahtabifard, Clark Fuller, Robert McKenna (2008)
            As thoracic surgery moves towards more minimally invasive procedures, such as video-assisted thoracic surgery (VATS) lobectomy, conversion from a VATS to open thoracotomy has been required for a sleeve resection. This article reports a large experience of VATS sleeve lobectomy. We reviewed our thoracic surgery database of more than 1500 VATS lobectomies for VATS sleeve resections. Preoperative, operative, and perioperative outcome variables, including morbidity and mortality were examined. Identified were 13 patients (median age, 59 years; range, 16 to 82 years) who underwent VATS sleeve lobectomy. There were no conversions to thoracotomy. Diagnoses included non-small cell lung cancer in 8 patients, typical carcinoid in 4, and metastatic sarcoma in 1 patient. Median tumor size was 2.1 cm (range, 0 to 6.6 cm). Median data were operative time, 167 minutes (range, 90 to 300 minutes); blood loss, 250 mL (range, 75 to 800 mL); chest tube drainage, 692 mL (range, 459 to 1590 mL); and chest tube duration, 3 days (range, 2 to 6 days). Median intensive care unit stay was 0 days (range, 0 to 4 days), and median hospital stay was 3 days (range, 2 to 8 days). No complications occurred in 9 patients (69%). Morbidity in the remaining 4 patients included 1 patient each with atrial fibrillation, anastomotic stricture, reintubation, and bronchial tear requiring repair. There were no deaths at 30 days. In experienced centers, VATS sleeve lobectomy is possible with acceptable morbidity and mortality as well as short length of stay.
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              Video-assisted sleeve lobectomy for mucoepidermoid carcinoma of the left lower lobar bronchus: a case report.

              Stefano Ferrero, A Giunta, Luigi Santambrogio … (2002)
              We report what we believe to be the first case of video-assisted sleeve lobectomy in an adolescent girl who had experienced recurrent episodes of lobar pneumonia and received a diagnosis of low-grade mucoepidermoid carcinoma of the left lower lobar bronchus.
              Article 0 comments Cited 22 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Thorac Cardiovasc Surg Rep
                Journal ID (iso-abbrev): Thorac Cardiovasc Surg Rep
                Journal ID (doi): 10.1055/s-00024355
                Title: The Thoracic and Cardiovascular Surgeon Reports
                Publisher: Georg Thieme Verlag KG (Stuttgart · New York )
                ISSN (Print): 2194-7635
                ISSN (Electronic): 2194-7643
                Publication date (Electronic): 25 October 2013
                Publication date (Print): December 2013
                Volume: 2
                Issue: 1
                Pages: 43-45
                Affiliations
                [1 ]Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
                Author notes
                Address for correspondence Hui Tian, MD Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Zhejiang Ningbo Xingninglu 57 Hao Ningbo, Zhejiang 315000China jojo816@ 123456163.com
                Article
                Publisher ID: 130034cr
                DOI: 10.1055/s-0033-1356749
                PMC ID: 4176062
                PubMed ID: 25360413
                SO-VID: de934733-8cb0-468e-bd42-8560d2d76ef0
                Copyright © © Thieme Medical Publishers
                History
                Date received : 23 June 2013
                Date accepted : 04 August 2013
                Categories
                Subject: Article

                Keywords: vats,sleeve lobectomy,both hands suturing
                Data availability:
                Keywords: vats, sleeve lobectomy, both hands suturing

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